Individual
ALYSSA MARINA-NICOLE GOODWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
405 KINGS CROSSING DR, CHARLOTTE, NC 28206-3870
(814) 528-1000
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15027
NC
101YP2500X
Professional Counselor
Primary
15027
NC
101YP2500X
Professional Counselor
8826
SC
Other
Enumeration date
08/14/2019
Last updated
02/19/2026
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